Adebowale Ogunseye Oguntola, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

97988 Issued in GA

Practice address

663 Lanier Park Dr
Gainesville, GA 30501-2059

Phone

(678) 450-0202

Fax

(678) 450-0080

NPI assigned

Nov 18, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nephrology

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kidney Care Center of Georgia LLCGroup PAC ID 9638200819, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fresenius Medical Care Habersham Dialysis facility, Demorest, GA, CCN 112800
• Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
• Northeast Georgia Medical Center Habersham Hospital, Demorest, GA, CCN 110041
• Northeast Georgia Medical Center Lumpkin Hospital, Dahlonega, GA, CCN 110237
• Union General Hospital Hospital, Blairsville, GA, CCN 110051

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations (25 of 28)

Interoperability endpoints

• Direct secure messaging: aoguntola@hiemail.healtheconnections.org
• Direct secure messaging: aoguntola62278@direct.acumenmd.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kidney Care Center of Georgia LLC

  • Nephrology Physician
  • Gainesville, GA
  • NPI 1588981187
  Medicare reassignment Care Compare group NPD
• Liverpool Dialysis Center LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Syracuse, NY
  • NPI 1689843385
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fresenius Medical Care Kidney Healthcare, LLC

  dba Fresenius Medical Care Habersham

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Demorest, GA
  • NPI 1144490889

  Dialysis facility

  Care Compare affiliation Name & address match
• NGMC Lumpkin, LLC

  • General Acute Care Hospital
  • Dahlonega, GA
  • NPI 1083174973
  Care Compare affiliation
• Northeast Georgia Medical Center Habersham LLC

  • General Acute Care Hospital
  • Demorest, GA
  • NPI 1740981430
  Care Compare affiliation
• Northeast Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Gainesville, GA
  • NPI 1427055821
  Care Compare affiliation
• Union County Hospital Authority

  dba Union General Hospital

  • General Acute Care Hospital
  • Blairsville, GA
  • NPI 1487684122
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1336121946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "663 LANIER PARK DR",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012059",
            "telephone_number": "678-450-0202",
            "fax_number": "678-450-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "663 LANIER PARK DR",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012059",
            "telephone_number": "678-450-0202",
            "fax_number": "678-450-0080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1304 Buckley Rd",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132124311",
            "country_code": "US",
            "telephone_number": "315-478-3311",
            "fax_number": "315-214-4847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OGUNTOLA",
        "first_name": "ADEBOWALE",
        "middle_name": "OGUNSEYE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "212959",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "97988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02076084",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS PROVIDER NUMBER",
            "identifier": "000025670",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chinenye Anulika Obicheta-Okeke, M.D.
• Brooke Anne Ochoa, OT
• Erica Oden
• Adebanke Olufunmilayo Oderinde, MD
• Amaka Ofuani
• Jason Sanghwa Oh, MD
• Seung Hwan Oh, MD
• Reid Ohearn, DMD
• Adebunmi Ojulari, M.D.
• Edward Maduabuchi Okeke, MSN, APRN, PMHNP-BC

• Nephrology Physician in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Nephrology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.